【方歌】乳岩初结核隐疼，肝脾两损气郁凝，核无红热身寒热，
速灸养血免患攻。耽延续发如堆栗，坚硬岩形引腋胸，
顶透紫光先腐烂，时流污水日增疼，溃后翻花怒出血，
即成败证气不灵。
【注】此证由肝、脾两伤，气郁凝结而成。自乳中结核起，初
如枣栗，渐如棋子，无红无热，有时隐痛。速宜外用灸
法，内服养血之剂，以免内攻。若年深日久，即潮热恶
寒，始觉大痛，牵引胸腋，肿如覆碗坚硬，形如堆粟，
高凸如岩，定透紫色光亮，肉含血丝，先腐后溃，污水
时津，有时涌冒臭血，腐烂深如岩壑，翻花突如泛莲，
疼痛连心。若复因急怒，暴流鲜血，根肿愈坚，斯时五
脏俱衰，即成败证，百无一救；若患者果能清心涤虑，
静养调理，庶可施治。初宜服神效栝蒌散，次宜清肝解
郁汤，外贴季芝鲫鱼膏，其核或可望消。若反复不应者
，疮势已成，不可过用克伐峻剂，致损胃气，即用香贝
养荣汤。或心烦不寐者，宜服归脾汤；潮热恶寒者，宜
服逍遥散，稍可苟延岁月。如得此证者，于肿核初起，
即加医治，宜用豆粒大艾壮，当顶灸七壮，次日起疱，
挑破，用三棱针刺入五、六分，插入冰螺散捻子，外用
纸封糊，至十余日，其核自落，外贴绛珠膏、生肌玉红
膏，内舒服肝、养血、理脾之剂，生肌敛口自愈。
又方：季芝鲫鱼膏
组成：活鲫鱼肉 鲜山药（去皮，各等分）
上共捣如泥，加麝香少许，涂核上，觉痒极，勿搔
动，隔衣轻轻揉之，七日一换，旋涂将消。
【方歌】鲫鱼膏贴乳岩疾，肿如覆碗似堆栗，山药同研加麝香，
涂于患处七日易。
又方：冰螺捻
组成：硵砂（二分）
大田螺（去壳，线穿晒干，五枚）
冰片（一分）
白砒（即人言，面果煨熟，去面用砒）
将螺肉切片，同白砒研末，再加硵片同碾细，以稠
米糊搓成捻子，磁罐蜜收。用时将捻插入铁孔，外用纸
糊封，贴核上勿动，十日后四边裂缝，其核自落。
【方歌】冰螺捻消诸核历，硵砂螺肉煨白砒，再加冰片米糊捻，
孔岩坚硬用之宜。
又方：神效栝蒌散（见乳劳）
香贝养荣汤（见项部上石疽）
清肝解郁汤、归脾汤（俱见乳中结核）
逍遥散（见背部上搭手）
绛珠膏、生肌玉红膏（俱见溃疡门）
[Formula Song] In the early stage of Ru Yan (Breast Cancer), a lump forms with dull pain, caused by damage to the Liver and Spleen and condensation of Qi stagnation. The lump is neither red nor hot, accompanied by alternating chills and fever; moxibustion should be applied promptly to nourish Blood and prevent internal invasion. If neglected and allowed to progress, the lump resembles piled chestnuts, hard as rock, with pain radiating to the axilla and chest. The apex turns purple and ulcerates, discharging foul fluid with increasing daily pain. After ulceration, the wound everts like flowers and bleeds profusely, indicating a "Bai Zheng" (Incurable/Defeat Syndrome) where vital Qi is exhausted.
[Note] This condition arises from injury to the Liver and Spleen, leading to Qi stagnation and condensation. It begins as a lump in the breast, initially the size of a date or chestnut, gradually enlarging to that of a chess piece, without redness or heat, sometimes with dull pain. At this stage, external moxibustion and internal blood-nourishing herbs are appropriate to prevent internal attack. If the disease persists for years, tidal fever and aversion to cold appear, followed by severe pain radiating to the chest and axilla. The swelling becomes hard like an inverted bowl, shaped like piled millet, protruding high like a rock, showing a purple luster, with blood streaks in the flesh. It first rots then ulcerates, oozing foul fluid, occasionally gushing bloody pus with a foul odor. The rotting depth resembles a ravine, and the everted edges resemble a lotus flower, with pain piercing the heart. If exacerbated by anger, causing sudden profuse bleeding, the root becomes harder; at this point, the Five Zang Organs are all depleted, constituting a Bai Zheng (Incurable Syndrome) with no hope of cure. However, if the patient can clear their mind, eliminate desires, and rest quietly, treatment may still be attempted. Initially, administer Shen Xiao Gua Lou San (Miraculous Trichosanthes Powder), followed by Qing Gan Jie Yu Tang (Clear Liver and Resolve Depression Decoction), and apply Ji Zhi Ji Yu Gao (Ji Zhi Crucian Carp Plaster) externally; the lump may resolve. If repeated treatments fail, the lesion is established; do not overuse harsh attacking agents to avoid damaging Stomach Qi; instead, use Xiang Bei Yang Rong Tang (Aucklandia and Borneol Nourishing Qi and Blood Decoction). For irritability and insomnia, Gui Pi Tang (Restore the Spleen Decoction) is suitable; for tidal fever and aversion to cold, Xiao Yao San (Free Wanderer Powder) is suitable, merely prolonging life. If treated when the lump first appears, use moxa cones the size of a bean, applying seven moxa burns directly on the apex. A blister will form the next day; puncture it, insert a three-edged needle 5-6 fen deep, place a Bing Luo Nian (Ice Snail Thread) soaked in Bing Luo San into the hole, seal with paper paste. After about ten days, the lump will fall off naturally. Apply Jiang Zhu Gao (Crimson Pearl Plaster) and Sheng Ji Yu Hong Gao (Generate Flesh Jade Red Plaster) externally, and internally take herbs to soothe the Liver, nourish Blood, and regulate the Spleen; the flesh will regenerate and the wound heal spontaneously.
Another Formula: Ji Zhi Ji Yu Gao (Ji Zhi Crucian Carp Plaster)
Composition: Fresh meat of live crucian carp, fresh Chinese Yam (Dioscoreae Rhizoma, peeled, equal parts)
Mash together into a paste, add a small amount of Moschus (She Xiang, Musk), and apply to the lump. Severe itching may occur; do not scratch. Gently rub through clothing. Change every seven days; apply continuously until it resolves.
[Formula Song] Apply Crucian Carp Plaster for Breast Cancer, where the swelling is like an inverted bowl or piled chestnuts. Grind Chinese Yam with Musk, apply to the affected area, and change every seven days.
Another Formula: Bing Luo Nian (Ice Snail Thread)
Composition: Borax (2 fen), Large River Snail (shell removed, threaded and sun-dried, 5 pieces), Borneolum Syntheticum (Bing Pian, Borneol, 1 fen), White Arsenic (Bai Pi, i.e., Realgar/Arsenic compound, baked in dough, discard dough, use only arsenic).
Slice snail meat, grind together with White Arsenic into powder. Add Borax and Borneol, grind finely. Mix with thick rice paste to form threads (Nian). Store in a porcelain jar sealed with honey. When using, insert the thread into the core of the lesion, seal externally with paper paste, keep immobile. After ten days, cracks will appear around the edges, and the lump will fall off naturally.
[Formula Song] Ice Snail Threads eliminate various old nodules; Borax, snail meat, and baked White Arsenic, combined with Borneol and rice paste threads, are suitable for hard, rock-like lesions.
Another Formula: Shen Xiao Gua Lou San (See "Ru Lao" chapter)
Xiang Bei Yang Rong Tang (See "Xiang Bu Shang Shi Ju" chapter)
Qing Gan Jie Yu Tang, Gui Pi Tang (Both see "Ru Zhong He Jie" chapter)
Xiao Yao San (See "Bei Bu Shang Da Shou" chapter)
Jiang Zhu Gao, Sheng Ji Yu Hong Gao (Both see "Kui Yang Men" chapter)